00:00: The next two, Health, General Health and Brain Health, are a little different ’cause they’re about probabilities. So let’s look at what happens with health benefits. And walking, just walking, the studies are absolutely, 100% conclusive. JoAnn Manson, study published in 1999, New England Journal of Medicine, surveyed 72,000 women for eight years, Perspective Study of Walking as Compared with Vigorous Exercise for the Prevention of Coronary Heart Disease in Women. The operative paragraph in the conclusion?  “The magnitudes of risk reduction associated with walking and vigorous exercise are similar when total energy expenditures are similar.”  It doesn’t matter how you expend the energy. You can do it walking, you can do it with exercise, as long as you do it.

00:52 : It has to do with… And there’s so many more studies. There are a lot in your handout. Just a couple more. Walking Versus Running for Hypertension, Cholesterol and Diabetes. 33,000 runners, 15,000 walkers. Walking and running produce similar reductions in cause specific disease mortality, people with hypertension and it goes on, and on, and on. So will walking get you there? Absolutely.

01:17 : Here’s another study. Looked at people who did steps, counted their steps. Looked at 200,000 people followed for six years. And was very simple. People who were basically sedentary, which is about 4,000 steps a day which you do anyway just to live, come to work, go to shopping, whatever, they considered that the baseline. And they said, “Okay, that’s sedentary. What happens if you… ” Get up to 7,000 steps they had a 41% reduction in all cause mortality?” 8,500 steps, 49%. 10,000 steps, 54%. Huge, huge reductions in all cause mortality. Biggest hit from zero reduction to 41% just adding 3,000 steps. Another 3,000 steps, you go from 41% to 54% reduction. But there’s a problem. The problem is that while this is absolutely true, it’s not now if you’re under 50. Because the real things which start to happen to people that relate to fitness, which is strokes, heart disease, cardiovascular disease, heart failure, diabetes, those things start to develop. When they do autopsies of young people, they find lots of plaque but they aren’t there enough to start causing problems, but around age 50, we start to see this happening. And so you say, “Yeah, but I’m 40, I’m 30, I’m 20.” So we have trouble with probabilities.

02:43 : If the weather forecast says there’s 50% chance of rain. What does that mean? Does it mean it’s gonna rain every other drop? No, it either rains 100% or rains 0%, right? And so how do you know if the weather forecaster knows what they’re doing? Well you’ve gotta look at 100 days where they forecast a 50% chance of rain and if on 49 of those days it rained 100%, they know what they’re doing. If only 10 of those days it rained, you know they haven’t a clue. But would you send your child off to school without an umbrella on a day where they said there was 50% chance of rain? Well, sure sometimes there wouldn’t be. But hey, it’s a pretty umbrella and it’s fun to carry. [chuckle] So why not? Take it with me.

03:29 : All this is statistical until it’s not. And it’s all very probabilistic until suddenly, it’s not. About a year and a half ago, my physician retired. New physician. Have a history of heart disease in the family but my cholesterol is fine. He said, “You know, there’s a new test you can take. It’s a CT scan. It measures calcium in your arteries, in your heart, coronary arteries. Tells you how much plaque you have.” I said, “Why do I need that?” He said, “It’d be good just to have a baseline. You have a history of heart disease in the family.” And I said, “I don’t know.” So I called my brother who was the one who turned me on to this physician. I said, “Hey, did Dr. Gelber ask you to do that?” He said, “Yeah.” What did you come out with it? He came out with zero calcium score. That’s great. It means he doesn’t have any plaque, right? So I said, “Alright, I’ll do that.”

04:13 : Now, if you have 400 that’s really bad. It means highly likely that one of your coronary arteries is severely blocked. Not totally, you’d have a heart attack but severely damaged. 1,000 means you’re a candidate for immediate open heart surgery. My score came back 1,738. Panic. Get a cardiogram, a Doppler cardiogram, echo cardiogram. It was okay. That measures how your heart pumps. So then they put me on a stress test with the nuclear, stick you with nucleotides, measure you under a camera. Then they get you in a stress test, then they stick you again and put you under the camera. From the time that test was finished, to the 15 minutes later when they brought me the results, I think was the longest 15 minutes in my entire life. ‘Cause I expected the doctor to come back and say, “I have scheduled you for emergency, quadruple bypass open heart surgery in the morning?” Instead he said, “You’re fine.”

05:14 : I said, “I don’t have any plaque?” He said, “Oh you have tons and tons of plaque. Your body makes plaque. Even though your cholesterol is fine, your body makes plaque. But what’s happened is your fitness has reformed the arteries so that they have adjusted, as the plaque has grown, they’ve adjusted. And you have no… What’s called perfusion defect. You have no blockages at all.” So it was, keep up your fitness regimen and see me in six months. So it’s all statistics until it’s not.  And so, you see, for 15 years, I carried that umbrella just to maintain my weight, feel energy. But am I glad I did that for those 15 years? Never knowing if it would one day save my life? Oh my, you have no idea. ‘Cause I probably wouldn’t be here talking to you today if I hadn’t.